NCCI edits for CPT 81228
CMS lists 9 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 578 pairs with modifier indicator 1, where an NCCI-associated modifier may be allowed when the documentation supports it.
NCCI release: Q4 2026. Source: CMS National Correct Coding Initiative (NCCI) Edits. Complete plain-text list.
Check a paired code Copy link
Medically Unlikely Edit (MUE) Copy link
The published MUE is 1 unit per patient per date of service.
Not separately payable together Copy link
Modifier indicator 0: the edit cannot be bypassed with an NCCI-associated modifier. Each row names the code that denies. CMS writes every edit as an ordered pair: the Column Two code is denied and the Column One code is paid.
Modifier may be allowed Copy link
Modifier indicator 1: an NCCI-associated modifier may be used when the circumstances and documentation support it. Each row names the Column Two code, which is the one denied absent an allowed modifier.
- 0001U 81228 denies
- 0004M 81228 denies
- 0005U 81228 denies
- 0006M 81228 denies
- 0007M 81228 denies
- 0008U 81228 denies
- 0009U 0009U denies
- 0010U 81228 denies
- 0011M 81228 denies
- 0012M 81228 denies
- 0013M 81228 denies
- 0016M 81228 denies
- 0016U 0016U denies
- 0017U 0017U denies
- 0018U 81228 denies
- 0019U 81228 denies
- 0022U 81228 denies
- 0023U 81228 denies
- 0026U 81228 denies
- 0027U 0027U denies
- 0030U 0030U denies
- 0034U 0034U denies
- 0036U 81228 denies
- 0037U 81228 denies
- 0040U 0040U denies
- 0045U 81228 denies
- 0046U 0046U denies
- 0047U 81228 denies
- 0048U 81228 denies
- 0049U 0049U denies
- 0050U 81228 denies
- 0055U 81228 denies
- 0060U 0060U denies
- 0068U 0068U denies
- 0069U 81228 denies
- 0070U 0070U denies
- 0071U 0071U denies
- 0084U 81228 denies
- 0086U 0086U denies
- 0087U 81228 denies
- 0088U 81228 denies
- 0089U 81228 denies
- 0090U 81228 denies
- 0101U 0101U denies
- 0102U 0102U denies
- 0103U 0103U denies
- 0108U 81228 denies
- 0111U 0111U denies
- 0112U 0112U denies
- 0113U 81228 denies
Showing 50 of 578. The plain-text version contains every pair.
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.